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| Multiple Myeloma |
Last updated: Nov 19, 2009 |
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It can lead to... | Recommendations
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Multiple myeloma is a type of cancer formed by malignant plasma cells. Normal plasma cells are an important part of the immune system. The immune system is composed of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. There are two types of lymphocytes: T cells and B cells.
When B cells respond to an infection, they mature and change into plasma cells. Plasma cells produce and release proteins called antibodies (or immunoglobulins) to attack and help kill disease-causing germs such as bacteria.
When plasma cells grow out of control, they can produce a tumor. These tumors can grow in several sites, particularly in the soft middle parts of bone marrow. When these tumors grow in multiple sites, they are referred to as multiple myeloma.
The overgrowth of plasma cells can interfere with the normal blood-forming functions of the bone marrow. This can result in a shortage of red blood cells and a condition called anemia. Anemia will cause fatigue. A shortage of blood platelets (cells that seal damaged blood vessels) can also occur. This can lead to excessive bleeding after cuts or scrapes. Another problem caused by an excess of plasma cells is leukopenia, a condition in which there is a shortage of normal infection-fighting white blood cells. A shortage of these cells causes decreased resistance to infections.
The abnormal plasma cells do not protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack specific infectious agents. For example, if you developed pneumonia normal plasma cells would produce antibodies that specifically attack and kill this type of bacteria. However, the antibodies produced by myeloma cells are not helpful in fighting infections.
Multiple myeloma is not the only disease involving excessive plasma cell growth. Two other forms of plasma cell disease are monoclonal gammopathy of undetermined significance (MGUS) and solitary plasmacytoma.
Solitary plasmacytoma is another category of plasma cell growth. Rather than multiple tumors in different locations as in multiple myeloma, there is only 1 tumor, hence the name "solitary" plasmacytomas.
Solitary plasmacytomas develop in bone marrow, or they may start in tissues other than bone marrow (such as the lungs or the lining of the sinuses, throat, or other organs). This is called extramedullary disease meaning outside the bone marrow. These tumors are treated by radiation therapy and/or sometimes with surgery. Their prognosis (outlook for recovery or survival) is usually excellent if no other plasmacytomas are found later on. However, most people with solitary plasmacytoma eventually develop multiple myeloma, especially if the plasmacytoma was in bone, and therefore need frequent examinations and tests to detect this progression as early as possible. Early treatment may lead to an improved outcome.
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Signs, symptoms & indicators of Multiple Myeloma: | |  | | | | Lab Values - Cells | High ESR or elevated ESR |
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Conditions that suggest Multiple Myeloma:
Risk factors for Multiple Myeloma: | |  | | | | Lab Values - Chemistries | Hypercalcemia | High blood calcium levels are also related to advanced bone damage seen in multiple myeloma. Because bone normally contains lots of calcium, bone destruction releases calcium into the blood.
Less than 1% of cases of high calcium are due to cancer... far less than 0.01% of cases of high calcium in people sitting in front of their computer are due to cancer).
The types of cancer known to be associated with high blood calcium are:
Multiple Myeloma (this is discussed separately below). Lung Cancer (squamous cell cancer of the lung, not all lung cancers) Breast Cancer (advanced disease) Kidney Cancer Squamous Cell Cancer of the Head and Neck
Multiple Myeloma. Multiple myeloma is a cancer (it is in the list above), but we write more about it here because it is the most common cancer cause of high calcium. Nearly half of all people with myeloma have hypercalcemia at some stage during their disease. Multiple myeloma is a cancer of the plasma cells (a type of white blood cell) that are found in the bone marrow. Plasma cells develop from B lymphocytes (a different type of white blood cell) and they produce antibodies that help the body fight infection (bacteria and viruses). When a plasma cell becomes malignant it will divide many times and produce many copies of itself that form tumors in the bone marrow. Over a period of years these tumor erode the inside of the bone, producing holes in the bones (called "lytic" lesions). Since the malignant cells are clones they all act exactly alike and they all produce the same antibody molecule that is secreted into the blood (this is what your doctor will measure).
Multiple myeloma is often detected during routine wellness testing where it shows up as an abnormally high amount of protein in the blood, a high calcium level, and often increased amounts of protein in the urine. To make the diagnosis your doctor will order a protein electrophoresis to be done. This test will examine the proteins in your blood to see if there is a large amount of one type of antibody present… and if there is, the diagnosis of multiple myeloma is made.
About 15% of patients that we see for parathyroid disease have had protein electrophoresis test performed to make sure they don't have multiple myeloma prior to them coming for treatment of their parathyroid disease. We believe that this is NOT necessary and this test is performed way too often. This is often done by endocrinologists who do not see parathyroid patients very often and they order a BUNCH of tests on your first visit (shotgun approach). Remember, almost everybody with high calcium will have parathyroid disease. If your doctor does not order a protein electrophoresis on your first visit, then good for them. You are almost guaranteed to never need it and you have a good doctor. [www.parathyroid.com] |
| Symptoms - Cancer |
History of multiple myeloma |
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Multiple Myeloma suggests the following may be present: | |  | | | | Diet | Dehydration | Most people with multiple myeloma need to drink a lot of fluid, as loss of fluid may cause kidney damage. You should drink two to three litres of fluid each day in the form of water. |
| Immunity |
Weakened Immune System | Multiple myeloma is one of many conditions that can cause a weakened immune system. |
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Multiple Myeloma can lead to:
Recommendations for Multiple Myeloma: | |  | | | | Drug | LDN - Low Dose Naltrexone | Lab Tests/Rule-Outs |
Digestive Enzymes / (Trial) | 166 subjects with multiple myeloma who took 2 Wobe-Mugos tablets (pancreatic enzymes) tid for the first year and then 1 tablet tid for the second year of the study, along with conventional treatement, experienced an extended lifespan (for stage III myeloma) from 47 months to 83 months over those who did not use the enzymes. The addition of oral enzyme therapy for more than 6 months reduced the hazard of death for patients at all stages of disease by approximately 60%. [Cancer Chemother Pharmacol, 2001;47(Supp1.):S38 S44 ] |
| Mineral |
Selenium | Nutrient |
Butyrate | Vitamins |
Vitamin K | Many patients on high dose chemotherapy for lymphoma or myeloma test positive for prothrombin precursor PIVKA II. These are proteins induced by vitamin K absence or antagonism. |
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KEY |  | Weak or unproven link |  |  | Strong or generally accepted link |  |  | Proven definite or direct link |  |  | Strongly counter-indicative |  |  | May do some good |  |  | Likely to help |  |  | Highly recommended |
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